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      Pattern of Pediatric Ocular Trauma in Kashan

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          Abstract

          Background:

          Ocular trauma is a significant health problem in pediatric patients.

          Objectives:

          The aim of this study was to analyze the characteristics of ocular-trauma-related hospitalization of children in Kashan.

          Patients and Methods:

          This descriptive, cross-sectional study included 131 children aged less than 16 years with ocular trauma, who were admitted to the Matini Hospital at the Kashan University of Medical Sciences between April 2006 and March 2009. After admission, detailed ocular examination was performed, and their ocular trauma was classified according to the International Ocular Trauma Classification and Birmingham Eye Trauma Terminology systems.

          Results:

          Mean age of the patients was 7.8 ± 2.2 years (age range, 0–16 years), and male to female ratio 5:1. The most common cause of admission was hyphema (38.1%), followed by corneoscleral laceration (27.5%). Ocular trauma most commonly occurred at home (43%), and 69% of the patients presented to the emergency room within 24 h of injury. In 30% of the patients, initial visual acuity at the time of presentation was less than 20/200 ( Figure 1).

          Conclusions:

          Ocular trauma is a major cause of unilateral blindness, especially in young boys, and hence, preventive measures and education is required.

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          Most cited references23

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          A system for classifying mechanical injuries of the eye (globe). The Ocular Trauma Classification Group.

          To develop a classification system for mechanical injuries of the eye. The Ocular Trauma Classification Group, a committee of 13 ophthalmologists from seven separate institutions, was organized to discuss the standardization of ocular trauma classification. To develop the classification system, the group reviewed trauma classification systems in ophthalmology and general medicine and, in detail, reports on the characteristics and outcomes of eye trauma, then established a classification system based on standard terminology and features of eye injuries at initial examination that have demonstrated prognostic significance. This system classifies both open-globe and closed-globe injuries according to four separate variables: type of injury, based on the mechanism of injury; grade of injury, defined by visual acuity in the injured eye at initial examination; pupil, defined as the presence or absence of a relative afferent pupillary defect in the injured eye; and zone of injury, based on the anteroposterior extent of the injury. This system is designed to be used by ophthalmologists and nonophthalmologists who care for patients or conduct research on ocular injuries. An ocular injury is classified during the initial examination or at the time of the primary surgical intervention and does not require extraordinary testing. This classification system will categorize ocular injuries at the time of initial examination. It is designed to promote the use of standard terminology and assessment, with applications to clinical management and research stud ies regarding eye injuries.
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            The Birmingham Eye Trauma Terminology system (BETT).

            To evaluate the international eye injury scene and design a standardized terminology for mechanical eye injuries. Surveys of practicing ophthalmologists and an extensive review of the international ocular trauma literature. Development of the Birmingham Trauma Terminology (BETT) using a logic-based approach. BETT always uses the entire globe as the tissue of reference. Its well-defined terms encompass all types of mechanical eye injury. A one-to-one relationship exists between terms and clinical conditions. BETT provides an unambiguous, consistent, simple, and comprehensive system to describe any type of mechanical globe trauma. Endorsed by several societies and peer-reviewed journals as the standardized international language of ocular traumatology, BETT is expected to become the preferred terminology for categorizing eye injuries in daily clinical practice.
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              A five-year retrospective study of the epidemiological characteristics and visual outcomes of patients hospitalized for ocular trauma in a Mediterranean area

              Background To determine the epidemiological characteristics and visual outcome of ocular trauma in southern Italy. Methods All cases of ocular trauma admitted to Department of Ophthalmology of Palermo University, Italy, from January 2001–December 2005 were retrospectively reviewed for open- or closed-globe injury (OGI or CGI). Data extracted included age, sex, residence, initial and final visual acuity (VA), cause and treatment of injury, hospitalization. The injuries were classified by Ocular Trauma Classification System (OTCS) and Birmingham Eye Trauma Terminology (BETT). We also referred to the Ocular Trauma Score (OTS) in evaluating the final visual outcome. Results Of the 298 eyes, there were 146 OGI and 152 CGI. Fifty eyes (16.8%) had an intraocular foreign body (IOFB). The annual incidence of eye injuries was 4.9 per 100,000. Most injuries occurred in men (84.6%, p < 0.0005), with an average age of 33.0 vs. 49.9 for women (p = 0.005). Cause of injury differed significantly by gender (p = 0.001) and urban vs. rural location (p = 0.009). The most frequent causes in men were outdoor activities related injuries (30.9%), work-related (25.4%), and sport-related (17.5%), and in women were home-related (52.2%) and outdoor activities related injuries (30.4%). In urban areas, road accidents were more frequent; in rural areas, work-related injuries were more frequent with a greater rate of IOFBs than in urban areas (p = 0.002). The incidence of OGI and CGI differed in work-related injuries (p < 0.0005), sport-related injuries (p < 0.0005), and assaults (p = 0.033). The final visual acuity was 20/40 (6/12) or better in 144 eyes (48.3%), 20/40–20/200 (6/12–6/60) in 90 eyes (30.2%), and <20/200 (6/60) or less in 46 eyes (15.5%). Eighteen eyes (6%) had a final acuity of no light perception. Of those eyes that presented with hand motion vision or better, 220 (86.6%) had a final vision of better than 20/200 (6/60). Initial visual acuity was found to be correlated with final visual acuity (Spearman's correlation coefficient = 0.658; p < 0.001). The likelihood of the final visual acuities in the OTS categories was correlated to that of the OTS study group in 12 of 14 cases (85.7%). Conclusion This analysis provides insight into the epidemiology of patients hospitalized for ocular trauma. The findings indicate that ocular trauma is a significant cause of visual loss in this population.
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                Author and article information

                Journal
                Arch Trauma Res
                Arch Trauma Res
                10.5812/atr
                Kowsar
                Archives of Trauma Research
                Kowsar
                2251-953X
                2251-9599
                01 June 2012
                Spring 2012
                : 1
                : 1
                : 35-37
                Affiliations
                [1 ]Trauma Research Centre, Kashan University of Medical Sciences, Kashan, IR Iran
                [2 ]Department of Ophthalmology, Kashan University of Medical Sciences, Matini Hospital, Kashan, IR Iran
                [3 ]Department of surgery, Shahid Beheshti University of Medical Sciences, Tehran, IR Iran
                Author notes
                [* ] Corresponding author: Davood Aghadoost, Trauma Research Center, Kashan University of Medical Sciences, Matini Hospital, Amirkabir Avenue, Kashan, IR Iran, Tel: +98-9131613628, Fax: +98-3615332900, E-mail: dawood_aghadoost@ 123456yahoo.com
                Article
                10.5812/atr.5302
                3955939
                24719840
                35e96826-b4b0-4e24-b58d-7042ee7705dd
                Copyright © 2012 Kowsar Corp.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 19 April 2011
                : 22 October 2011
                : 28 February 2012
                Categories
                Original Article

                hospitalization,injury,pediatric,patients
                hospitalization, injury, pediatric, patients

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